Management of Infected Mesh after Laparoscopic Incisional Hernia Repair

ABSTRACT

Laparoscopic repair using mesh is a standard technique for ventral hernia repair. Complications of laparoscopic ventral hernia repair increase according to the increment of laparoscopic repair. Subcutaneous emphysema and mesh infection are major complications of laparoscopic repair of ventral hernia. The principle of management of infection is removal of a foreign body. However, in the case of repair with mesh, removal of infected mesh induces recurrence of hernia. Preservation of mesh is the best option for treatment of infected mesh. We have experienced treatment without removal of mesh in a case of infected subcutaneous emphysema after laparoscopic ventral hernia repair. The infection spread slowly to mesh and seroma. Drainage and debridement of infected tissue and evacuation of infected seroma resulted in healing of the infection without removal of mesh.